Commercial Insurance Fraud

Feb. 27: Week That Was in Healthcare Fraud and Malpractice

by Jacqueline DiChiara

Here is a general roundup of the past week’s developments in healthcare fraud and malpractice, as reported by the Department of Justice. The crimes reported below result in multiple millions of...

Feb. 20: Week That Was in Healthcare Fraud, Malpractice

by Jacqueline DiChiara

Here is a general roundup of the past week’s developments in healthcare fraud and malpractice, as reported by the Department of Justice. The crimes reported below result in multiple millions of...

February 13: The Week That Was in Healthcare Fraud and Legality

by Ryan Mcaskill

A recap of high-profile charges, convictions and sentencing involving healthcare legality ending the week of February 13, 2015. The United Stated Department of Justice has put a stop to a number of...

February 6: The Week That Was in Healthcare Fraud and Legality

by Ryan Mcaskill

A recap of high-profile charges, convictions and sentencing involving healthcare fraud ending the week of February 6, 2015. The United Stated Department of Justice has put a stop to a number of...

Various Forms of Fraud Hurting Hospital Revenue

by Ryan Mcaskill

Whether internal or by patients, fraud is causing problems for hospital revenue cycles. Regular readers are aware of the different ways that a healthcare provider or practitioner can see its revenue...

January 30: The Week That Was in Healthcare Fraud and Legality

by Ryan Mcaskill

A recap of high-profile charges, convictions and sentencing involving healthcare fraud ending the week of January 30, 2015. The United Stated Department of Justice has put a stop to a number of...

The Week That Was in Healthcare Fraud and Legality

by Ryan Mcaskill

A recap of high-profile charges, convictions and sentencing involving healthcare legality ending the week of January 23, 2015. The United Stated Department of Justice has put a stop to a number of...

The Week That Was in Healthcare Legality

by Ryan Mcaskill

A recap of high-profile charges, convictions and sentencing involving healthcare legality ending the week of January 9, 2015. Healthcare is a multi-billion dollar industry. It is also a hot bed for...

The Week That Was in Medical Billing Fraud

by Ryan Mcaskill

A recap of some high-profile charges, convictions and sentencing involving Medicare and Medicaid claims. The United Stated Department of Justice has put a stop to a number of different high-value...

Health Billing Company Settles with FTC Over Deceptive Tactics

by Ryan Mcaskill

A settlement between the FTC and PaymentsMD was reached over a deceptive practice use to capture patient information. Across the healthcare landscape, organizations are looking for ways to improve...

CMS Strengthens Medicare Provider Safeguards with New Rule

by Ryan Mcaskill

A new final CMS rule will be make participation in Medicare incentive programs more difficult for bad actors. Earlier this week, RevCycleIntelligence.com covered a report from the Government...

Five Associations Back Lawsuit Against Illegal Medical Billing

by Ryan Mcaskill

A lawsuit in Canada about illegal medical billing is supported by several human rights and social justice associations. While the focus of the healthcare landscape in the United States is on open...

Medicaid Pediatric Dental Services Abuse Found in Indiana

by Ryan Mcaskill

In 2012, 94 general dentists and one oral surgeon in Indiana used incorrect Medicaid billing for $30.5 million in services. Recently, the Office of Inspector General of the Department of Health and...

New York City, CSC Sued for Tens of Millions in Medicaid Fraud

by Jennifer Bresnick

New York City and a contracting company are accused of a massive Medicaid fraud scheme relying on automated software. Federal prosecutors are suing New York City and Computer Sciences Corporation (CSC)...

$350M Kickback Fine Can’t Derail Future of Dialysis Provider

by Jennifer Bresnick

DaVita HealthCare has paid $350 million to settle kickback allegations, but has continued on with a large acquisition while garnering national praise. Despite paying $350 million to the Justice...

Ex-Hospital CEO, Doctors Guilty of $400M in Medicare Fraud

by Jennifer Bresnick

A number of different racketeers have been convicted of more than $400 million in fraudulent Medicare billings. The Attorney General’s Office has quashed a number of different high-value Medicare...

Medical Billing Company Pays $1.95M in Fraud Settlement

by Ryan Mcaskill

National medical billing company Medical Business Service (MBS) reached a settlement this week with the United States Attorney’s Office over allegations of defrauding the Medicare and Medicaid...

Medical Billing Errors Increase Consumer Healthcare Debt

by Ryan Mcaskill

There is no question that medical bills can easily get out of hand if consumers do not keep them in check. Without proper insurance and an understanding of what the coverage actually means, debt can...